From the Research
Introduction to Acute Otitis Media (AOM)
Acute Otitis Media (AOM) is a common condition characterized by inflammation of the middle ear, often caused by bacterial or viral infections. Healthcare providers should be aware of the risk factors, prevention methods, signs, symptoms, and treatment options for AOM.
Risk Factors for AOM
The risk factors for AOM include:
- Exposure to household tobacco smoke 1
- Bottle-feeding instead of breastfeeding 2, 1, 3
- Attendance at family or small-group day care for infants and toddlers 1
- Lack of immunization against influenza and pneumococcal infections 1, 3
- Genetic predisposition 4
Prevention Methods for AOM
Prevention methods for AOM include:
- Breastfeeding 4, 2, 1, 3
- Avoiding exposure to household tobacco smoke 2, 1
- Immunization against influenza and pneumococcal infections 1, 3
- Using xylitol 2
- Probiotics and vitamin supplementation may be beneficial 2
Signs and Symptoms of AOM
The signs and symptoms of AOM include:
- Ear pain (otalgia) 3, 5
- Fever 3
- Irritability 3, 5
- Otorrhea (discharge from the ear) 3
- Anorexia 3
- Vomiting or lethargy 3
- Rubbing, tugging, or holding the ear may be a sign of pain in young children 3
Treatment Options for AOM
Treatment options for AOM include:
- Pain management with analgesics
- Observation or antibiotics, depending on the patient's age, severity of symptoms, and whether the AOM is unilateral or bilateral 3
- High-dose amoxicillin (80 to 90 mg per kg per day in two divided doses) is first-line therapy unless the patient has taken amoxicillin for AOM in the previous 30 days or has concomitant purulent conjunctivitis 3
- Alternative antibiotics such as amoxicillin/clavulanate, cefdinir, or azithromycin may be used in cases of penicillin allergy or recent use of amoxicillin 3, 5
- Tympanostomy tubes may be considered in children with recurrent AOM 4, 3, 5
- Surgical intervention may be introduced and studied as a diagnostic, therapeutic, and preventive measure for AOM, but its effectiveness is still being researched 5
Differential Diagnosis and Caveats
It is essential to differentiate AOM from other conditions, such as acute otitis externa, and to consider the potential for overdiagnosis and injudicious antibiotic use, which can contribute to antibiotic resistance 5. Healthcare providers should work with parents to determine the best course of management, particularly if observation is the primary intervention 5.